MaineCare and MaineCare Managed Care and Medicaid

We bill MaineCare for inpatient and outpatient services, if you provide proof of coverage (i.e. a MaineCare card) at the time of service.

MaineCare may require prior approval for services by patients and/or their primary care providers (PCP's) before services can be covered. This is called pre-authorization. If you have MaineCare Managed Care, you need to contact your PCP for pre-authorization.

MaineCare may have a "spend down," or "co-pay."

A spend down is a semi-annual expense that you must pay before your MaineCare benefits can begin. This amount can vary depending on income, assets, or where the service is delivered (i.e. your doctor’s office vs. a large hospital).

A co-pay is a set amount paid each visit based on the service or a dollar amount.

At Northern Light Health, we’re building a better approach to healthcare because we believe people deserve access to care that works for them. As an integrated health delivery system serving Maine, we’re raising the bar with no-nonsense solutions that are leading the way to a healthier future for our state. Our more than 12,000 team members are committed to making healthcare work for you: our patients, communities, and employees.